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HomeMy WebLinkAbout20-1275 City of Zephyrhills PERMIT NUMBER s - 5335 Eighth Street -= Zephyrhills, FL 33542 FIRE-001275-2020 V Phone: (813)780-0020 1. Fax: (813)780-0021 Issue Date: 01/13/2021 Permit Type: Fire Property Number „ ; Suet Address 24 26 21 0000 00100 0013 3752 Copeland Drive Owner Informationatj M Permit Information Contractor Information Name: COPELAND FAITH PARTNERS LLC Permit Type:Fire Contractor: FIRE FIGHTER, INC. Class of Work:Sprinkler System Address: 5025 Hartford St Building Valuation:$0.00 TAMPA,FL 33619 Electrical Valuation:Phone: (813)340-1787 Mechanical Valuation: Plumbing Valuation: Total Valuation:$0.00 ' Total Fees:$150.00 Amount Paid:$150.00 Date Paid:1/13/2021 10:52:40AM Project Description INSTALLATION FIRE SPRINKLER Application Fees Sprinkler System Plan Review $50.00 Fire Alarm Permit Fee(1-25) $50.00 Sprinkler Permit Fee $50.00 REINSPECTION FEES: (c)With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c)the local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or first reinspection,whichever is greater,for each subsequent reinspection. Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permit required from other governmental entities such as water management, state agencies or federal agencies. "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing,consult with your lender or an attorney before recording your notice of commencement." Complete Plans,Specifications add fee Must Accompany Application.All work shall be performed in accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O. NO OCCUPANCY BEFORE C.O. C TRACTOR SIGNATURE PE IT OFFICE PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Fire Fax-813-780-0021 Permit Application Date Received �. 11 77 Phone Contact for Permit Owner's Name 8►io4 L Owner's Phone Number 1� Owners Address 5 0 -�©� S� P9 414A33 6 Fee Simple Titleholder Name Titleholder Phone Number Fee Simple Titleholder Address Job Add-reps 5 5 Z Lot# Sub Division Parcel# v 6 0 +d d do 3 Bio-Hazard Waste Storage-ANNUAL Fum(gation Tent. Comm Exhaust Kitchen Hood/Duct Hazardous Material(Tier II or RQ Facility)ANNUAL Controlled Bum Hood Installation Emergency Generator<30 kw LP/Natural Gas-Installatior Emergency Generator>30 kw LP/Natural Gas-ANNUAL Sale 0 Fire Protection Maintenance-ANNUAL Places of Assembly-ANNUAL ® em MI / jam► Sprinkler ❑ ❑ ElRebreationai Bum / / / f`% Fire Alarm ❑ ❑. ❑ El Sparklers r - Hood Cleaning ❑ ❑ ❑ C Sprinkler System Installations u� Hood Suppression El ❑ ❑ ❑ Standpipes(Sprinkler Sys) Fire Alarm Installation = Torch Roofinglrar Kettle Fire Pumps ED Waste Tire Storage.ANNUAL R Flammable Application-ANNUAL Valuation of Project Fuel Tanks Other: Contractor Company SignatureA Registered Y/N Fee Cu t -�Y/N Address License# ELECTRICIAN Company Signature Registered Y/N Fee Current Y'/,�N Address License# PLUMBER Company Signature Registered Y/N Fee Current Y/N Address License# MECHANICAL Campany Signature Registered Y/N Fee Current Address License# OTHER Company Signature Registered Y/N Fee Current Y/N Address License# Directions: Fill out application-completely. Owner&Contractor sign,back of.appimation,not-dzed-(OY;copy of signed contract with owner) If over$2500,a Notice of Commencement is required(Mechanical work over$5000) Supply two(2)sets of drawings�with applicable documentation Allow 10714 days for review after submittal date. 1 Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) ^ � NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deedo restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR (RESPONSIBILITIES: If the owne.r has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required. by law, both the owner and contractor may be cited for a misdemeanor viQlation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for.the intended work,they are advised to contact the Pasco CbUnty Building Inspection Division—Licensing Section at 727-847- 8000. Furthermore, if the -owner has hired a contractor or contractdrs, he is advised to have the cointradtor(s) sign portions of the ucontractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco C ONSTRUCTION LIEN LAWAChapter 713, Florida-Statutes,as amended): If valuation of work is$2,500.00 or more, I certify that 1, the ppplica. ht, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide" prepared by the F.lorida Di I�pdrtmeht of Aigricultute and Consumer Affairs. If the applicant is sdrr teone other than the"owner", I.certify that I hive obtained a copy of the above described doc ument and promise in good faith to deliver it to the uowner"prior to comm.encemOnt. CONTRACTORISJOWNER'S AFFIDAVIT: I certify that all the Information in this application Is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land ~~.e~~p.,~~~. Application that no work or installation has commenced*prior to issuance of a permit and that all work Will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations Of other government agencies may apply to the intended woft, and that it is my responsibility to ld ei6tify what actions I must take to be in compliance. If I am the AGENT FOR THE OW_hkR, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit Issued shall be construed to be 6 license to proceed with the work and not as authority to violate, cancel, alter,or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the-work authorized by such permit is commenced within six months of permit issuance, or'l work au' thbrized by the permit is suspended or abandoned for a period of six(6)months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety(90) days and will demonstrate justifiable cause for the extension. If work ceases for ninety(90)consecutive days,the job is considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD.A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR A' N' ,AtTO' RN'EY BEFORE RECORDING YOU"OT- ICE OF COMMENtEMENT. OWNER OR AGENT CONTRACTOR, . Subscdbed and sworn to(or affiffned)before me this Subscribed and sworn to(or affim Ve )l5efore ni—eth s Who islare personally known to me or has/have produced Who istryien=nown to me or has/have produced as identification. ----as identification. Notary Public Notary Public Commission No. Commission No. Name of Notary typed,printed or stamped Name of Notary typed,printed or stamped Expites JOB '�----- � / ® DATE(MM/DD/YYYY) AJ►��o CERTIFICATE OF LIABILITY INSURANCE s/2/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Thalia Kin Adcock-Adcock Insurance Agency PHONE FAX 315 W. Fletcher Ave. A/c No Ext:813-933-6691 Alc No): Tampa FL 33612-3414 ADDRESS: thaliak@adcock-insurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:FCCI Insurance Co. 10178 INSURED 843 INSURERB: Ironshore Specialty Insurance Co. 25445 Fire Fighter, Inc P O Box 888 INSURER c:Auto-Owners Insurance Co. 18988 Land O Lakes FL 34639-1317 INSURERD:Evanston Insurance Co 35378 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:432975609 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF FOLIC EXP LIMITS LTR B X COMMERCIAL GENERAL LIABILITY RCS00002-07 9/6/2020 9/6/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) ccurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 X POLICY❑JPRO ❑LOC PRODUCTS-COMP/OP AGG $2,000,000 ECT OTHER: $ C AUTOMOBILE LIABILITY 5300057700 9/6/2020 9/6/2021 COEaMBINED accident SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acciden tt PIP-Basic $10,000 D UMBRELLA LIAB X OCCUR REN OF XOBW8272819 9/6/2020 9/6/2021 EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DIED RETENTION$ $ A WORKERS COMPENSATION WC010005999101 9/6/2020 9/6/2021 XPER JOTH- AND EMPLOYERS'LIABILITY AND ER ANYPROPRIETOR/PARTNER/EXECUTIVE Y� N/A E.L.EACH ACCIDENT $1,000,000 OFFICERWEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Zephyrhilis St AUTHORIZED R FS N vE Zeph Zephyrhirhilis FL 33542 � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 7PAQCOCOUNTY BUSENESs TAx REcEiPT 2021 Issued pursuant and subject to Florida Statutes and Pasco County Ordinances. Issuance does not certify Expires September 30th compliance with zoning or other laws. This receipt must be posted conspicuously in place of business. VA� MIKE FASANO ACCOUNT#:: 15123 TYPE OF BUSINESS TAX MLLCTOR WHOLESALE FIRE EXTINGUISHERS ,LE SIC CODE: 5099.00 pASW COUNTY FLORIDA STATE LICENSE# OWNER/QUALIFYING AGENT BLAIR GARY FIRE FIGHTER INC LOCATION ADDRESS: PO BOX 888 4330 ALPINE RD LAND 0 LAKES,FL 34639-0888 LAND 0 LAKES,FL 346394021 DATE RECEIPT AMOUNT 08/28/2020 20-1-117179 30.00